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Laureen Nakamoto posted a reply on Re: Medicare Denials

Wednesday, Nov 5, 2025 at 5:07 PM

Said: This is the website that Medicare is sending us to refer to regarding denials. It is The Joint Commission library. The changes are for Joint Commissioned Accredited laboratories.

James Beck posted a reply on Re: Medicare Denials

Wednesday, Nov 5, 2025 at 4:51 PM

Said: You are correct. I was just looking at a Certificate of Waiver for one of our locations and there are no specialties/types of testing listed. There doesn't even appear to be a place to put it. Thought maybe the...

Jennifer Ballard posted a new Topic

Wednesday, Nov 5, 2025 at 4:44 PM

iSTAT hs-TnI on Patients w/ >55% Hct

For those of you already using the hs-TnI cartridge on iSTAT, are you running whole blood or plasma? If whole blood, what is your process for patients with a HCT >55%? Our thought was to add a disclaimer to all results but we're not sure that's the best option since so many people overlook a disclaimer and it's rather important to know if you need to repeat this test. We have a fairly high volume so checking every patient's HCT is not feasible and running ALL tests on plasma won't sit...

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Alex Stewart posted a reply on Re: Medicare Denials

Wednesday, Nov 5, 2025 at 4:42 PM

Said: Look into Physician Specialty codes to help with what they're looking for; this will be a 2-digit alphanumeric different from CPT's.

Cindy Engbert posted a new Topic

Wednesday, Nov 5, 2025 at 4:19 PM

Medicare Denials

I have been asked to help troubleshoot why we are getting denials for our waived PT testing. We are using 85610QW for the CPT. Our CLIA certificate is a Certificate of Waiver. When our claims specialist reached out to Medicare, they said we needed to have a specialty code, and sent her a CLIA certificate application to complete. I am confused, because the specialty section is only for non-waived testing. Has anyone else experienced this?

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